Finding The Right Health Insurance For You

Private health insurance gives you peace of mind and more flexibility with your healthcare. The right health insurance coverage can safeguard you and your loved ones against some of the costs of unplanned or unexpected medical treatments in the private hospital system (Private Hospital cover) and for services not covered by Medicare in the public system (Extras).

Private health insurance also helps by covering the full MBS schedule fee for hospital and medical fees while in hospital. Medicare covers 75% of the MBS fee, and health insurance can cover the extra 25% that’s not covered by Medicare in the private hospital system. Without it, you run the risk of having to pay added costs in the event of emergency situations, specialist medical treatments, or rehabilitation in the private hospital system.

Considering your individual needs

Everyone is different, which can make choosing the right insurance coverage overwhelming for you. If you’re wondering how to pick the most suitable health insurance plan, it all starts by looking closely at your unique needs.

Whether you’re a couple planning a pregnancy, a student who’s active and healthy, or you’re getting older and in need of regular medical attention, you need to consider that budget, age, lifestyle, and relationship status all play a part in the decision-making process.

Understanding your life stage

For Australians keen to take a proactive approach to their health care, private health insurance offers more flexibility and security, which in turn can allow you to live a fuller life.

Let’s say you’re a keen runner and you’ve just signed up to your first fun run marathon. While a well-considered training plan is key, pounding the pavement week after week can take a toll on your body. It’s no surprise then that the option of hospital insurance coverage and extras cover, which includes physiotherapy, can help you cross the finish line without injuries.

Let’s consider the main life stages in private health insurance

Please note that the names and people mentioned below are fictional characters.

I’m young and single

Sarah (24) is an advertising creative. She purchased her own cover when she turned 24 as she was no longer covered by her parent’s health insurance. She spends her spare time trail walking and trekking with her friends. She’s always been physically active but knows she needs to be careful during some of the more dangerous trips. After reviewing medical insurance plans for individuals, Sarah has taken out basic level health coverage to help her afford some of the potential out of pocket costs if an unfortunate accident occurs and she wishes to be treated privately.

We’re a couple

Ready to take the next step in their relationship, Lisa (29) and Pete (31) recently purchased an inner-city two-bedroom apartment. They both work full-time, and enjoy evenings at home or dining with friends. While they share similar interests and needs, Lisa and Pete are also keen to grow their family. They’ve agreed to take out cover as part of a couples health insurance policy which covers them for obstetrics so they can chose their doctor and get a private room if available, and extras to help with things like physio throughout the pregnancy.

I have a family

Looking after three kids under 15 can be a handful at the best of times. If Paul (49) and Jackie (46) aren’t driving their youngest daughter to her weekly gymnastics classes, they’re accompanying their son to the optometrist, or paying for braces for their eldest. Thankfully, their family cover offers free preventative dental for kids and helps with some of the cost for the orthodontics. Things sure are busy in the Jackson household, but with comprehensive cover Paul and Jackie ensure their family have access to the best practitioners and treatments.

I’m getting older

After their kids moved out, Liz (74) and Trevor (77) relocated to a small terrace house where they didn’t have to worry about stairs. These days, Trevor’s arthritis is causing him a bit of pain, and since Liz had her hip replacement they’ve found it more and more difficult to manage their own medical care. Thanks to their couples comprehensive cover with ambulance cover included, the pair have access to medical services whenever they need it rather than waiting in the public system.

Key factors

Considering your life stage when choosing health insurance can help you maximise the value you receive for services and treatments that you, or your family, need.

Buying health insurance: a timeline

Please note that the graphic below, and the use of the “age 31” is only in relation to the Lifetime Health Cover loading (LHC).

Choosing health insurance and purchasing a policy before you turn 31 will ensure you don’t have to pay extra loading if you require cover later on in life.

If you consider choosing health insurance later in life (any time after your 31st birthday), you will have a 2% premium loading that increases annually by 2% for every year you don’t have private hospital cover, it caps out at 70%. This loading is added to your premium if you purchase private hospital cover, it’s removed once you’ve had hospital cover for 10 consecutive years, and you never have to pay it again as long as you continue to keep your private health hospital cover. See privatehealth.gov.au for more details.

If you want to be covered for obstetrics (pregnancy and birth-related services) in a private hospital and with a private obstetrician, add this to your policy a minimum of 3 months before you fall pregnant as the total waiting periods is 12 months.

Most Australians with private health coverage receive a rebate from the Australian Government to help make their cover more affordable. On a taxable income of under $140,000 as a single, or $280,000 as a family, you are eligible for a rebate between 8.4% and 33.8%, depending on your age and income level.

Everyone’s situation is different, so being able to choose the right level of private health cover to fit your lifestyle and budget is key.

Time to review

Alternatively, you can search on iSelect to compare your profile against policies from our participating health funds.

We don’t compare all health insurance providers or policies in the market. The availability of policies will change from time to time. Not all policies available from our partners are compared by iSelect and due to commercial arrangements, your stated needs and circumstances, not all policies compared by iSelect will be available to all customers. Some policies are available only from our call centre and others are available only from our website. Click here to view our range of providers.